Why a Vitamin D Test Is More Important Than a Mammogram

October is national Breast Cancer Awareness Month in the U.S., and with it comes the annual clarion call of pink-ribboned1 breast cancer awareness campaigns.2 National Mammography Day3 falls on the third Friday of October, which this year is the 19th.

Chances are, you've been barraged with reminders that mammograms save lives. Unfortunately, little effort is made to educate women about actual prevention. Detecting cancer has nothing to do with prevention. At that point, it's already too late.

Generally speaking, research has shown that once you reach a minimum serum vitamin D level of 40 nanograms per milliliter (ng/mL), your risk for cancer diminishes by 67 percent, compared to having a level of 20 ng/ml or less.4

Research shows most cancers occur in people with a vitamin D blood level between 10 and 40 ng/mL, and the optimal level for cancer protection has been identified as being between 60 and 80 ng/mL.

Vitamin D also increases your chances of surviving cancer if you do get it,5,6,7,8 and evidence suggests adding vitamin D to the conventional treatment for cancer can boost the effectiveness of the treatment.9

Several studies also show that higher vitamin D levels are protective against breast cancer specifically. Importantly, a 2005 study10 showed women with vitamin D levels above 60 ng/mL have an 83 percent lower risk of breast cancer than those below 20 ng/mL, and I cannot think of any other strategy that can offer that kind of risk reduction. Mammograms certainly cannot.

More recently, a pooled analysis11 published in June 2018 of two randomized trials and a prospective cohort study came to a near-identical conclusion. The objective was to assess whether there are any benefits to having a vitamin D level above 40 ng/mL, as most studies do not venture into these higher levels.

Indeed, mirroring the 2005 findings, women with vitamin D levels at or above 60 ng/mL had an 82 percent lower incidence rate of breast cancer than those with levels of 20 ng/mL or less.

Pooled data were analyzed in three different ways. First, incidence rates were compared based on vitamin D levels ranging from 20 to 60 ng/mL. Next, statistical analysis using Kaplan-Meier plots were done. Third, multivariate Cox regression was used to examine the association between various vitamin D levels and breast cancer risk. According to the authors:

"Results were similar for the three analyses. First, comparing incidence rates, there was an 82 percent lower incidence rate of breast cancer for women with 25(OH)D concentrations ≥60 vs <20 ng/mL.

Second, Kaplan-Meier curves for concentrations of <20, 20–39, 40–59 and ≥60 ng/mL were significantly different, with the highest proportion breast cancer-free in the ≥60 ng/ml group (99.3 percent) and the lowest proportion breast cancer-free in the <20 ng/ml group (96.8 percent). The proportion with breast cancer was 78 percent lower for ≥60 vs <20 ng/mL.

Other Studies Linking Vitamin D Status With Cancer Risk

Several other studies also support the hypothesis that higher vitamin D levels are powerful cancer prevention, including but not limited to the following:12

Menopause, 2018 — Just last month, research13,14 published in the journal Menopause found that postmenopausal women who receive a diagnosis of breast cancer are more likely to be vitamin D deficient and overweight than women who receive a negative diagnosis. Overall, breast cancer patients were 1.5 times more likely to have low vitamin D.

The BMJ, 201815 — Earlier this year, a Japanese study published in The BMJ concluded that higher vitamin D levels were associated with a 20 percent lower relative risk of internal cancers in both sexes. Equally important, they found there was no increased risk for any type of cancer associated with higher vitamin D levels.

PLOS One, 201616,17 — This pooled analysis of a randomized trial and a prospective cohort study found that women aged 55 and older who had a vitamin D serum level of 40 ng/ml or greater had a 67 percent reduced risk of cancer compared to those with a vitamin D level of 20 ng/ml or less.

Cancer Causes & Control, 201318 — In this case control study, those who had a vitamin D level of 35 ng/mL or higher were 70 percent less likely to develop breast cancer compared to those with a level of 15 ng/mL or less.

PLOS One, 201119 — Here, women with a vitamin D level of 30 ng/mL or higher had a 60 percent lower risk of breast cancer than those with a level of 20 ng/mL or below. Among post-menopausal women, the risk was 71 percent lower.

Cancer Epidemiology, Biomarkers & Prevention, 200920 — In this case control study, premenopausal women with a vitamin D level of 34 ng/mL or higher had a greater than 60 percent reduction in breast cancer risk compared to those with a level of 24 ng/mL or lower.

Carcinogenesis, 200721 — Postmenopausal women with a vitamin D level of 30 ng/mL had a nearly 70 percent reduced risk of breast cancer compared to those with levels of 12 ng/mL or less.

American Journal of Clinical Nutrition, 2007 — Women over 55 who raised their average serum level to 38 ng/mL lowered their risk of all invasive cancers, including breast cancer, by 77 percent.22

Anticancer Research February 2011 — In this study, breast cancer patients with high vitamin D levels were twice as likely to survive than those with low levels.23,24,25 (Higher vitamin D levels are also associated with a lower risk of severe peripheral neuropathy in cancer patients.26)

This Breast Cancer Awareness Month, Get Your Vitamin D Level Checked

This year, do your breast health a real favor and get your vitamin D level checked. One of the easiest and most cost-effective ways of doing this is to enroll in the D*Action Breast Cancer Prevention project, which now includes both vitamin D and omega-3 testing.

Their new myData-myAnswers personalized health software is now able to "give you feedback on your health conditions compared to thousands of others so you can make more informed decisions on your actions." GrassrootsHealth also has a handy vitamin D calculator that can help you determine how much vitamin D you need per day to get to 60 ng/mL or above.

You can enroll in this cancer prevention project either on the GrassrootsHealth website, or by ordering the vitamin D testing kit, either alone or in combination with the omega-3 test, from my online store. All revenues from these kits go directly to GrassrootsHealth. I make no profit from these kits and only provide them as a service of convenience to my readers.

As noted on GrassrootsHealth's D*Action Challenge27 webpage, before you donate money to a breast cancer prevention group, find out whether the group has any focus on primary prevention, opposed to just mammograms. Are they actually trying to eliminate breast cancer, or are they just pushing for detection? Secondly, check to see whether the group recommends vitamin D testing as a key prevention strategy.

Again, research has clearly demonstrated that having a vitamin D level of at least 40 ng/mL, and ideally between 60 and 80 ng/mL,28 can massively reduce your risk of breast cancer.

As noted by GrassrootsHealth, "If the answers are 'YES' to both challenges, then the women stand to gain quickly, significantly, safely and inexpensively." If not, your money is probably not going to do much good, seeing how there's been no change in breast cancer incidence in over a decade, despite the many millions collected in donations.

According to data published in the Archives of Internal Medicine,29 75 percent of American adults and teens are deficient in vitamin D, based on a sufficiency level of 30 ng/mL. This means at least three-quarters of the female population in the U.S. could lower their risk of breast cancer by 60 to 80 percent.

If the sufficiency cutoff were to be moved to 40 or 60 ng/mL, deficiency rates in the U.S. would likely be in the high 90 percent bracket. The take-home message is that the vast majority of people do not have vitamin D serum levels that are high enough to prevent cancer, and this is so easy and inexpensive to fix!

So, please, if you haven't done so already, make vitamin D optimization your goal during this year's breast cancer awareness month, and share the news with all the other women in your life.

Be Mindful of the Interplay of Vitamins D and K2, Calcium and Magnesium

As for how to raise your vitamin D level, remember that the best way is through sensible sun exposure. That said, many will need oral supplementation to achieve an optimal level, especially if you're pregnant in the wintertime.

Just remember that if you take high-dose oral vitamin D, you may also need to increase your intake of calcium, magnesium and vitamin K2 as well, as these four nutrients work in tandem and rely on sufficient amounts of each to work properly. Importantly, inadequate levels of vitamin K2 in combination with high vitamin D intake may cause overabsorption of calcium, which in turn can result in calcium deposits in your heart and kidneys.

Maintaining an appropriate calcium-to-magnesium ratio30 is also important, as magnesium helps keep calcium in your cells so they can function better. A ratio of 1-to-1 appears to be ideal.

Magnesium is also required for the activation of vitamin D. Without sufficient magnesium, taking a vitamin D supplement may be ineffective,31,32 essentially making it appear you need unnecessarily high amounts. If your magnesium level is too low, the vitamin D will simply get stored in its inactive form, doing you absolutely no good.

According to recent research,33 as many as 50 percent of Americans taking vitamin D supplements may not get significant benefit due to insufficient magnesium levels. On the other hand, when you have an optimal magnesium level, your vitamin D level will rise even if you're taking a much lower dose.34 To learn more about this, see "Without Magnesium, Vitamin D Supplementation May Backfire."

Pink-Washing — Beware the Pink Ribbon Scam

While there are many different breast cancer prevention charities, the Susan G. Komen Foundation35 is perhaps the most well-known. It has done a great deal of harm to women by obfuscating the authentic preventative measures available to combat breast cancer and downplaying the preventive role of a healthy diet, vitamin D optimization and limiting chemical exposures, while heavily promoting mammography.

By ignoring the role your lifestyle plays in the development of cancer, organizations such as these can continue to collect billions of dollars of donations in the name of "finding a cure." Meanwhile, effective prevention could eliminate the need for finding a cure altogether. As noted in a 2014 article by Karuna Jaggar, executive director of Breast Cancer Action:36

"Few people realize that Breast Cancer Awareness Month (BCAM) was launched by Astra Zeneca, a pharmaceutical company that sells cancer treatments on the one hand and carcinogenic pesticides on the other. So BCAM has all along been one big marketing campaign — arguably the most successful marketing campaign of the 20th century.

This is why at Breast Cancer Action, we call October 'Breast Cancer Industry Month,' the month when corporations make money professing how much they care about breast cancer by selling pink ribbon products ...

How many of the ingredients contained in a random selection of pink products are toxic and bad for our health? No one knows because of weak chemical regulation in the United States that's outdated ...

We can't waste another October watching corporations make money off pink ribbon products that contain toxins linked to breast cancer. If you are outraged, take a stand to protect all of us from toxic chemicals that are making us sick because the manufacturers of pink ribbon products certainly won't."

Mammograms Do More Harm Than Good and Have No Impact on Mortality Rates

Mammography can detect invasive breast cancer in women. This is not in dispute. What is in dispute is whether or not routine mammograms are really the right tool to reduce breast cancer rates, and whether it might harm more women than it helps in the process.

A growing body of evidence suggests that it does in fact, on the whole, do more harm than good by generating high rates of false positives that lead to unnecessary treatment and associated emotional trauma.37 Those who opt for aggressive treatment such as a mastectomy, radiation and/or chemotherapy after a false positive diagnosis undergo physical pain and suffering "for nothing."

However, since you're unlikely to ever find out that you didn't have life-threatening cancer after all, women who believe their lives were saved by mammography will be hard-pressed to buy into the idea that routine mammograms are more harmful than helpful.

Still, statistics suggest many breast cancer survivors are not actually survivors of breast cancer, they're survivors of breast cancer treatment.38 Several studies have completely demolished the notion that mammograms save lives. For example:

• A 2015 study published in JAMA Internal Medicine39 found mammography screenings lead to unnecessary treatments while having virtually no impact on the number of deaths from breast cancer.

• Another 2015 study40 published in the Journal of the Royal Society of Medicine declares its conclusion right in the title, which reads: "Mammography screening is harmful and should be abandoned."

In short, decades of routine breast cancer screening using mammograms has done nothing to decrease deaths from breast cancer, while causing more than half — 52 percent — of all women undergoing the test to be overdiagnosed and overtreated. According to lead author Peter C. Gøtzsche, had mammograms been a drug, "it would have been withdrawn from the market long ago."

• A 2012 study41 in The Lancet concluded that for every life saved by mammography screening, three women are overdiagnosed and treated with surgery, radiation, or chemotherapy for a cancer that might never have given them trouble in their lifetimes. Additionally, no positive correlation with mortality could be found.

Computer Analysis Does Not Improve Accuracy of Mammograms

Research42 also shows the use of computer-aided detection (CAD) for mammography, which is used in 90 percent of U.S. mammograms at a cost of $400 million a year, does nothing to improve the accuracy of the test.

The study looked at more than 625,000 mammograms from nearly 324,000 women to determine whether CAD actually improves a radiologist's interpretation of a mammogram or not. As it turns out, CAD had no beneficial impact on mammography interpretation, leading the authors to conclude that: "These results suggest that insurers pay more for CAD with no established benefit to women."

In fact, radiologists were actually more prone to miss cancer when using CAD compared to when not using it. Overall, radiologists correctly identified cancer 90 percent of the time when CAD was not used, and only 83 percent of the time when they used CAD.

Take Control of Your Cancer Risk

In closing, remember to get your vitamin D level checked, and if below 60 ng/mL, take steps to raise your blood level. If you're looking for a scientifically proven way to avoid being a breast cancer statistic, optimizing your vitamin D is at the very top of the list.

Again, the level you're aiming for is between 60 and 80 ng/mL, with 40 ng/mL being the low cutoff point for sufficiency to prevent a wide range of diseases, including cancer.

As for dosage, you need to take whatever dosage required to get you into the optimal range. Research43 suggests it would require 9,600 IUs of vitamin D per day to get 97 percent of the population to reach 40 ng/mL, but individual requirements can vary widely. As mentioned, your magnesium status is a very important factor that can play a role in your required dosage, but there are many other individual factors as well.

If you've been taking a certain amount of vitamin D3 for a number of months and retesting reveals you're still not within the recommended range, then you know you need to increase your dosage. Over time, with continued testing, you'll find your individual sweet spot and have a good idea of how much you need to take to maintain a healthy level year-round.